The effect of antibiotic therapy on recovery after adenotonsillectomy in children

Abstract

Objective:This prospective study was to evaluate the role of perioperative antibiotics use in children after adenotonsillectomy. Methods:A total of 117 children undergoing adenotonsillectomy admitted to the Department of Otolaryngology Head and Neck Surgery of Shanghai Children's Hospital from November 2021 to June 2022 were collected and randomly divided into observation group （61 cases） and control group （56 cases）. The observation group was not given antibiotics before and after operation, but was given saline instead. The control group received ampicillin sulbactam sodium intravenously 30 min before surgery and the day after surgery. SPSSv. 21.0. was used for statistical analysis, and χ² test was used to evaluate postoperative bleeding and fever between the observation group and the control group. Two independent sample mean T-test was used to evaluate the throat pain score consecutive 3 days after the surgery, the time to resume to normal diet and the wound healing time between the two groups. The correlation between age and postoperative pain was assessed by linear correlation analysis. Results:Three cases of hemorrhage in the observation group （4.9%） and 2 cases of hemorrhage in the control group （3.6%）. There was no significant difference between the two groups （χ² =0.129, P =0.719）. The wound repair time was （18.25±2.353） d in the observation group and （18.05±2.711） d in the control group, and there was no significant difference between the two groups （P =0.671）. The Pearson correlation coefficient between age and pain score was 0.071 on the first day after surgery, 0.115 on the second day and 0.243 on day third day. Pearson correlation coefficient between age and time of pain disappearance was 0.136, with no statistical significance （P>0.05）. The difference of postoperative body temperature between the two groups was statistically significant （χ²=20.525, P<0.01）, perioperative antibiotic use was a protective factor for preventing postoperative fever （OR=0.167）; The pain scores were 6.52±1.963, 5.87±2.093, 5.02±2.149 in the observation group and 4.82±1.820, 4.18±1.759, 3.04±1.907 in the control group on day 1 to 3 after surgery, respectively. The difference between the two groups was statistically significant （P<0.01）; The time of pain disappearance was （7.36±2.483） days in the observation group and （5.14±2.004） days in the control group, and the difference between the two groups was statistically significant （P<0.01）. Conclusion:Perioperative use of antibiotics in children with adenotonsillectomy can effectively reduce postoperative fever, throat pain symptoms and shorten the pain time.